Viability of tissues of the extremities and surgical tactics in stage IV arteriosclerosis obliterans

: Amputation of the extremity was performed in 26 of 52 patients with the IV stage obliterating atherosclerosis. Clinical severity of the disease was confronted with results of special investigations. Three groups of such patients are described: with traumatic necroses, with ischemic necroses and with necrotic ischemia (criteria of its irreversibility are presented). Surgical tactics of treatment in the first group of patients may include sympathectomy with necrectomy. The outcome of treatment of the second group patients is determined by the efficiency of reconstructive operations. Amputation of the extremity is indicated to patients of the third group.